Abstract

Introduction

Developed countries pay more attention to the place at which residents die, but little is known about this topic with respect to China. Given its recent economic development, the distribution and factors associated with place of death in a developed area of China may display unique characteristics. The aim of this study was to determine the current distribution and characteristics of residents’ place of death in the Chongwen district of Beijing and to analyze the factors associated with the place of death.

Methods

Data on residents’ place of death from 2007 to 2012 in the Chongwen district of Beijing were collected from the Death Cases Reporting System of China. We determined the distributions and trends of place of death and analyzed the factors associated with place of death via univariate and logistic regression analyses.

Results

The average proportion of residents who died at an inpatient hospital ward was 49.2% in the Chongwen district of Beijing and displayed an increased trend from 2006 to 2012 (χ2=4.240, P=0.039). Gender, age, marital status, education level, occupation and cause of death were associated with place of death (P<0.001). Being widowed (odds ratio (OR)=1.193), divorced (OR=1.415), having a low education level (middle school: OR=1.381; primary school: OR=1.705; or illiterate: OR=1.923), being unemployed (OR=1.690) and suffering from cardiac disease (OR=2.063) were risk factors for dying outside a hospital ward. Male gender (OR=0.082), being in the 75-84 year age group (OR=0.721) and suffering from cancer (OR=0.374) or respiratory system disease (OR=0.608) were associated with a reduced risk for dying outside a hospital ward.

Conclusions

The proportion of residents who died at a hospital ward in the Chongwen district of Beijing was higher than that of the overall country of China and was similar to that of developed countries. Residents with low education levels, who were unemployed, and who were not married were more likely to die outside the hospital. Policy-makers should focus on effectively assisting low-income residents in obtaining resources for end-of-life medical care. These results emphasize the difficulties with medical and mental care for elderly individuals who live alone.